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Monday, April 8, 2013

“Sexy” MS Research

I guess my
fascination with the immune system started when I was a kid with bad asthma. I
was always on steroids or some type of shot, and I didn’t understand why other
kids were well when I wasn’t. Why was my immune system so over reactive
compared to other kids? Doctors were heroes who made me feel better (even with
all the shots), and that heroism was part of what drew me to medical school. I also
loved learning about the
brain – which is really “who we are.” This made the study of the immune
system attacking the brain a perfect area for my career.

Fast forward
to today, 22 years into a career studying multiple sclerosis. One area I focus
on is studying gender differences in MS. Women get MS three or four times as
often as men, and when men do get MS it’s usually more progressive. Why? That’s
the sexy part – sex differences I mean. To this end, we are pursuing whether
differences in sex chromosomes or normally circulating levels of sex hormones
impact disease susceptibility and disease progression.

Another area is
related to pregnancy. In the third trimester of pregnancy, women with MS see up
to a 70 percent reduction in relapse rates. So, my research teams and I are currently
testing
pregnancy levels of the hormone estriol administered in a daily pill
(hormone or placebo) to non-pregnant women with MS. In our two-year
multi-center trial where all participants have relapsing-remitting MS and use
Copaxone, the primary outcome measurement is frequency of relapses. In our
new one-year trial, the primary outcome
measurement is cognitive improvement; this trial includes women with relapsing
remitting as well as secondary progressive MS who use any FDA-approved disease-modifying
treatment.

We’re testing
estriol primarily because it’s unique to pregnancy, it’s safe, and because it
helped improve lost cognitive function when administered to mice with
experimental autoimmune encephalomyelitis (EAE: the “mouse form” of MS). Mice
with EAE have cognitive effects similar to those in MS – demonstrated by their
behavior and in lost nerve endings (called synapses) – and in mice with the MS
model of disease, estriol treatment improves that behavior and rebuilds those nerve
endings. Amazing!

I hope you’re
as excited as I am at how close this means we are to finding a treatment that
is neuro-protective (serving to protect neurons/nerves from injury or
degeneration) and could therefore have disease-halting capabilities, and maybe
even some improvement effects. How novel that a naturally occurring, safe
pregnancy hormone could prove to protect neurons from further damage,
effectively stopping MS in its tracks! We’ll share results in 2014 and 2015.

Today,
thousands of people are gathered at our nation’s capital for the Rally for
Medical Research – to raise awareness of the critical need to make funding for
the National Institutes of Health (NIH) a priority. You don’t have to be there
in person to show your support! My
research would not be possible without funding from the NIH and the National MS
Society. While the pharmaceutical industry is extremely important to bring new therapies
to market, it’s hard for them or other investors to support research into products
such as naturally occurring hormones or generic solutions because they won’t be
as profitable. Academics like me are out there doing novel research toward new
treatments not only to slow MS, but to stop and reverse it, through the pathway
of NIH, Society and other generous donor funding and partnership. You can
support this pathway, not just through donations
to the Society, but through activism. Ask
your member of Congress to preserve funding for the NIH – it’s one email
with a potentially HUGE response.

If I had to
give one piece of advice to people with MS, it would be: please keep faith that
the treatments are coming – they’re getting better all the time! There are
thousands of people like me who go to work every day to bring you better and
more treatment options; comment below if you want to hear more about our sexy
MS research.

7 comments:

Hooray for you Dr. Voskuhl! I am one MS patient who is totally convinced hormones play a vital role in MS. I am currently seeking to undergo a complete hysterectomy because my MS symptoms are SO severe 2-5 days before my period. I am literally in the bed for a week before my period. I am so thrilled to see what your research finds. Thank you. Thank you for your lifelong dedication to my disease.

Thank you for your research! This is incredibly fascinating to me. When I was 17 years old I was diagnosed with PCOs but I've been overweight my entire life. I was diagnosed with multiple sclerosis at age 23, and weighed 300 pounds (despite eating a relatively average diet). Recently, while doing my own research because doctors kept turning me away, I discovered a study showing a possible connection between congenital adrenal hyperplasia and multiple sclerosis. Up until that point, I had never even heard of CAH but when I found out that women with my possible heritage are often misdiagnosed as having PCOs- I was flabbergasted. When I showed the study to my primary care doctor, the only doctor who has ever taken me seriously, she agreed to get me an appointment with an endocrinologist. The appointment isn't until June, but I have high hopes that it will narrow down the connection between hormones and MS, at least for me, but I hope it will also open doors for others out there who question- what is wrong with me?I can't be the only one, who, since childhood, has had that question. I'd love to hear from anyone else with similar stories.

Wow!!! Lots of wows, millions of thanks, zillions of congrats. Thanks to scientists like you, we do keep on "faithing" -new verb created seconds ago while switching mode spanish to mode english-.I'm argentinian, MS patient, MS has low incidence in Argentina. Married to a swedish guy, lived in Sweden for a couple of years, divorced and returned to Argentina. In Sweden MS has a 250/100.000 ratio, in Argentina 10/100.000. Amazing, isn't it? Anyway, I'm thankful to be the MS "carrier" and not my kids, as they would have more genetic possibilities than me. Well, they are boys, and that's a great advantage. Thank you again, Doctor. Hugs and keep on! By the way, I am 51 yo and didn't menopause yet. Don't want to, as I believe hormons in my blood stream have a certain task to perform. One of my boys studying in Medical School and explained to me that there are supplements and I shouldn't worry. But you know, every patient is a theories'creator. Another one created by my exhusband is that when living in Sweden I had a misscariage and was transfused swedish blood. One of the boys was born with blood incompability (mediterranean -me- and scandinavian -the father-. So, it doesn't sound sooooo crazy. Anyway, my contribution to you is my high respect, admiration, and eternal gratefulness. I was detected 5 years ago, on Natalizumab since 2010, on wheelchair but no episodes since started with Tysabri.Thanks again, again and again.Oh! another interesting point is that I was raised in Brasil, so I was exposed to sun my whole childhood and adolescence...and was social smoker for some years, but quit 10 yrs ago...noraespector@gmail.com

Thank you for your commitment to MS research, Dr. Voskuhl! I was delighted to see the focus of your new trials being cognitive function. I am one of those MS patients who suffer no ambulatory problems, nor do I have numbness/tingling in my limbs like many patients with whom I have spoken or read. Cognition and vision (thin retinal nerve fiber layer) have been the targets of my MS. Anything that might help at least keep my cognitive function stable (or, dare I hope -- improve!), has my full attention. My career depends on it, as I am also a research scientist (not in the medical field).

We need to see encouraging posts like this. My daughter in law was diagnosed with Primary Progressive MS about 1 1/2 years ago, and as the mother of triplet 5 year old girls, she needs a cure, or at least something that will halt the progress of this disease. THANK YOU for working diligently to find a cure!

After my diagnosis, I went out & bought the book "Multiple Sclerosis for Dummies." I quickly learned of my potentially bleak future & was eager to do anything to prevent...everything. My doctor referred me to Dr. Voskuhl, where I learned about this clinical trial. One of my first contacts for this trial just happened to be an author of the MS for Dummies book! Instant credibility! For the next 2 years, I took my daily estriol (or placebo) pill and felt better than I have in the past 6 years. I hope it was the real thing & I hope it gets approved ASAP!

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